Basic Information


    I give permission for my child/children to participate in Lordswood Leisure Centre funtime trips. I understand they may be traveling to them by coach

    Medical Conditions

    My child/children have the following medical conditions and or/allergies, if this form is to be used for multiple children, please indicate which condition and/or allergy is for which child. In the event of a medical emergency, do you give consent for a member of staff to sign any forms on your behalf should the delay of obtaining a signature be considered inadvisable by the doctor?

    Emergency Contacts

    Emergency Contact 1:
    Emergency Contact 2: